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26 Cards in this Set

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tetrodotoxin (TTX)
Class: local anaesthetic
Action: blocks Na+ ch. at sites near extracellular surface; blocks conduction w/o change in RMP.
procaine
Class: ester-type local anaesthetic
Short duration of action, rel. potency of 1.
chloroprocaine
Class: ester-type local anaesthetic
Duration: short
Rel. Potency: 1
cocaine
Class: ester-type local anaesthetic
Duration: med
Rel. Potency: 2
tetracaine
Class: ester-type local anaesthetic
Duration: long
Rel. potency: 16
mepivacaine
Class: amide-type local anaesthetic
Duration: medium
Rel. potency: 2
prilocaine
Class: amide-type local anaesthetic
Duration: medium
Rel. potency: 3

Notes: metabolite o-toluidine can oxidise Hb to methemboglobin.
lidocaine
Class: amide-type local anaesthetic
Med. duration of action, rel. potency of 4.
bupivacaine
Class: amide-type local anaesthetic
Duration: long
Rel. potency: 16
Notes: cannot be given I.V. due to potential for severe cardiotoxicity; not suitable for intravenous block.
ropivacaine
Class: amide-type local anaesthetic
Duration: long
Rel. potency: 16
Nitrous Oxide
Class: inhaled GA
Action: inhibits NMDA RR
Toxicity: no sig. short-term toxicity or met. Will expand pockets of trapped gas. Inhibits methionine synthetase; megaloblastic anaemia with extended exposure.
Potency: poor
Analgaesia: good
Notes: use 70% N2O in conjuction with other GAs.
Halothane
Class: Inhaled GA
Analgesia: slight
Sk Mm relax.: slight
Pungency: low; pt. friendly.
Solubility: int.
Side effects/tox.: myocardial depressant, sensitises myocardium to catecholamines. Dose-dependent ↓BP. F- toxic. ↓renal bloodflow. ↑intracranial pressure, due to sm mm relaxation (vasodilation). Halothane Hepatitis 1/35,000 chance.
Notes: "gold standard".
Isoflurane
Class: Inhaled GA
Action:
Solubility: less than halothane.
Potency: less than halothane
Analgesia:
Pungency: more than halothane.
Toxicity: less than halothane; less met.
Side effects: ↑'d HR, but mainatains C.O.
Notes: potentiates tubocurarine
Enflurane
Class: Inhaled GA
Action:
Potency: less than halothane
Analgesia: more sk mm relaxation than halothane.
Pungency: more than halothane.
Toxicity: less than halothane; less met.
Side effects: less bradycarida, less likely to sensitise to catecholamines. Less ↑ in intracranial pressure.
Contra: may exacerbate seizures.
Notes: not commonly used.
Methoxyflurane
Class: Inhaled GA
Action:
Potency: high; highly soluble, low MAC.
Toxicity: high (due to high solubility), esp. nephrotoxicity.
Analgesia:
Notes: No longer in wide use. Long recovery time.
Sevoflurane
Class: Inhaled GA
Action:
Potency: lower
Analgesia:
Sm mm: good relaxant; bronchodilation.
Toxicity: more than isoflurane due to higher met.
Pungency: Low
Notes: excellent control, rapid induction/recovery.
Desflurane
Class: Inhaled GA
Action:
Potency: lower; low solubility, quick induction/recovery.
Pungency: high; use IV induction.
Analgesia:
Toxicity: little met.
Side effect: ↑HR, maintains C.O.
Notes: Suited for ambulatory surgery; quick recovery.
thiopental
Class: IV GA
Action: Activates GABA-A R, ↑s Cl- conductance, hyperpolarises.
Potency: low; rapid induction, short duration.
Analgesia:
Side effects: Cardiovascular/respiratory depressant. Unpredictable hypersensitivity reactions due to sulfur grp.
Contrain: weakly basic drugs, because thiopental is a poorly soluble weak acid.
Notes:
methohexital
Class: IV GA
Potency: 3x higher than thiopental.
Duration: 2x shorter
Midazolam
Class: benzodiazepine used as IV GA
Solubility: higher than diazepam.
Half-life: 3 hours
Analgesia: none, but induces anterograde amnesia
Side effects: less cardio/resp. effects than most barbituates.
Notes: flumazenil reverses.
Ketamine
Class: IV GA,
Action: inhibits NMDA RR, like N2O.
Effect: dissociative anaesthesia. No generalised relaxation.
Analgesia: good, suitable for burn pts.
Side effects: cardiovascular stimulant, hallucinations, ↑s intracranial/intraocular pressure.
Etomidate
Class: IV GA
Analgesia: none
Advantages: preserves resp. stability, C.O.
Side effects: myoclonus, adrenal suppresion (thus used only for induction). Painful to inject.
Propofol
Class: IV GA
Advantages: rapid recovery, anti-emetic properties. Suitable for day-surgery.
Side effect: very resp. depressive; transient apnea, ↓BP, pain on injection, contamination of lipid vehicle.
Contra: cardiac disease.
fentanyl
Class: narcotic as IV GA
Effect: opioid anaesthesia.
Analgesia: good
Half-life: shorter than other opioids.
Side effects: severe resp. depression, minimal cardiovascular depression, mm rigidity.
Notes: naloxone for reversal.
Droperidol
Class: IV GA
Effect: neuroleptanaesthesia, anti-emetic, anti-fibrillatory/convulsant.
Dexmedetomidine
Class: α2-agonist used as IV GA.
Effect: sedative/analgesic properties, conscious sedation.
Half-life: shorter than most α2-agonists, rapid recovery.
Notes: metabolised in liver by esterases, used in veterinary medicine.